Brain tumors are one of the most, If not the most, difficult problems in cancer. There is only one known cause, high doses of radiation used to treat other malignancies, and that cause only accounts for less than 1% of brain tumors. Since so little is known of the cause, there is no effective prevention, and there are no tests for early detection, such as exist for breast, cervical, and prostate cancer. Treatment is toxic and minimally ineffective. Surgery is limited by the inability to remove areas of the brain involved by tumor that control speech, personality, memory and movement. Radiation destroys normal brain over time and impairs memory function. Most drugs are ineffective and no drugs, with the exception of temozolomide and more recently avastin, more effective than those introduced in the 1970s have been developed. Furthermore, brain tumors in childhood are particularly challenging, because of the difficulties in diagnosing diseases in patients who may not be particularly verbal about their symptoms, the inadequacies of current therapy, the failure of many hospitals to provide comprehensive multidisciplinary care, the nihilism many health care professionals display regarding therapy for these patients, and (as a result of the relative rarity of pediatric brain tumors) the paucity of organizations actively promoting or funding research devoted to improving treatment. There are few organized adult neuro-oncology training programs in the United States which offer expertise in both laboratory and clinical investigations and stress the critical need to train physicians or physician-scientists who are proficient in clinical and or laboratory neuro-oncology research. There are few full time dedicated pediatric neuro-oncologists in the United States and fewer if any programs devoted to the training of pediatric neuro-oncologists. This lack of physicians or physician-scientists investigators who are trained to conduct clinical or laboratory research in neuro-oncology is a major impediment to the field to conducting translational research designed to advance the therapy of pediatric and adult patients with brain tumors. This T32 application is designed to train new neuro-oncology physicians or physician-scientists who can lead future efforts in clinical, translational or basic research in this field. RELEVANCE: Brain tumors remain a challenging health issue for those patients who are diagnosed with them. This grant will train physicians or physician-scientists who can advance the field and care for these patients.